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UWorld Wrongs > Start 5/1 > Flashcards

Start 5/1 Flashcards

1
Q

What class are Anti-Rh Abs?

A

IgG

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2
Q

Socially inhibited, but desires relationships with others=

A

Avoidant

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3
Q

Psychosis that presents with and WITHOUT mood symptoms

A

Schizoaffective

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4
Q

What medications are associated with osteoporotic fractures?

A

Proton pump inhibitors (omeprazole; bc dec absorption), anticonvulsants that increase p450 (phenytoin, phenobarbital, carbamazapine), drugs that dec. estrogen (progesterone, and aromatase inhibitors), GnRH antagonists, and glucocorticoids, heparin, thiazolidineiones.

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5
Q

Abx for lung abscess / aspiration pneumonia?

A

Clindamycin

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6
Q

Hyperacusis is associated with CN:

A

7 (Facial) - the Stapedius muscle is bad

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7
Q

Fabry Disease early and LATE manifestations-

A

angiokeratomas, hypohidrosis, acroparethesia

RENAL FAILURE

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8
Q

Go to high elevation, what happens to O2?

A

It decreases (~60) until about 10-14 days when Hb increases

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9
Q

Warfarin induced necrosis is from

A

Protein C or S deficiency

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10
Q

What is the virulence factor of Strep. pyogenes that prevents phagocytosis? What factor lyses erythrocytes?

A

M-protein (prevents phago)

Streptolysin O lyses RBCs

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11
Q

What are the functions of beta1 block?

A

Decreased cAMP in the heart and in the KIDNEY JGA APPARATUS!

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12
Q

Vasopressin increases absorption of what, where?

A

H20 and UREA at the medullary collecting duct

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13
Q

ABs to the alpha chain of collagen type 4 will present with

A

hemoptysis and oliguria (goodpastures)

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14
Q

What type of incontinence is seen with MS?

A

Urge- detrusor muscle overactivity from loss of inhibitory innervation

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15
Q

17-alpha hydroxylase deficiency in males presents as-

A

External vagina, internal male genitalia, and increased minealcorticoids so hypokalemia.

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16
Q

What about thiazide diuretics can cause muscle cramps?

A

Hypokalemia

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17
Q

What about mycoplasma treated with erthyromycin can cause anemia?

A

Cold agglutins becuase Mycoplasma is similar to RBCs and when the body attacks it also destroys some RBCs (Nothing to do with tx)

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18
Q

Congenital bicuspid aortic valves cause

A

Aortic stenosis in 60s (accelerate the calcific stenosis process of old age)

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19
Q

Erosion vs ulcers (layers?)

A

Erosion- mucosa –> muscularis mucosa

Ulcer - mucosa –> muscularis mucosa –> submucosa

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20
Q

When is bhcg detectable after fertilization?

A

urine- 14 days

serum- 8 days

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21
Q

Terminal bronchiole clears debris by

A

Cilia!!!! (no more goblet cells)

This is the last site of cilia

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22
Q

How do you get HAV?

A

Fecal-Oral (like raw oysters)

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23
Q

VHL (auto dominant) presents with?

A

Cerebellar hemangioblastoma with congenital cysts (kidney, liver, pancreas)

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24
Q

Biggest concern during the recovery phase of ATN is:

A

hypokalemia

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25
Q

Thin stratum granulosum with prominent parakeratotic stratum corneum-

A

Psoriasis

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26
Q

What is the cause of fever, muscle rigidity, tachycardia, and hypertension after surgery?

A

Malignant hyperthermia (abnormal ryanodine receptors cause large intracellular calcium release)

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27
Q

How do you treat malignant hyperthermia? (mechanism)

A

Dantrolene- prevents Ca release from the sarcoplasmic reticulum of skeletal muscle by acting on ryanodine

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28
Q

AV shunts ___ preload and ___ afterload.

A

increase preload and decrease afterload

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29
Q

Conduction speed of atrial muscle vs ventricular muscle?

A

Atrial muscle is FASTER

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30
Q

Cirrhosis causes increased estrogen. One manifestation is gynecomastia, what are others?

A

SPIDER ANGIOMATA, testicular atrophy, and decreased body hair.

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31
Q

In primary osteoporosis, PTH is ____ and Ca++ is ___

A

normal and normal

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32
Q

What tumors are s100+ ?

A

Schwannoma and melanoma

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33
Q

Describe the vaccine that should be used to protect older people against pneumococcal pneumonia

A

Outer polysaccharide covering conjugated to a protein antigen

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34
Q

Why do kids get H.flu. ear infections despite vaccination?

A

The strains responsible do not produce capsules

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35
Q

GLUT4 location

A

skeletal muscle and adipocytes

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36
Q

Where do glucocorticoids increase protein synthesis?

A

Liver (because steroids increase liver gluconeogenesis and therefore catabolize all peripheral tissues to supply the liver with substrates)

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37
Q

How does Zidovudine (AZT) work?

A

Competitively binds RT and is incorporated as a thymidine analog WITHOUT a 3’-OH group, therefore making 3’-5’ phosphodiester bind formation impossible.

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38
Q

What causes a cauliflower like mass in the intestine and mucous diarrhea?

A

Villous adenoma

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39
Q

Why are reticulocytes blue?

A

rRNA

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40
Q

Saccular vs Charcot-Buchard aneurysm

A

Saccular - circle of willis; subarachnoid hemorrhage

C-B- chronic htn and affects small vessels

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41
Q

Most common cause of recurrent lobar hemorrhagic stroke in the elderly?

A

Amyloid angiopathy!

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42
Q

What gastroenteritis bacteria can be acquired from pets? (Bonus- what serious complication is this bacteria associated with?)

A

Campylobacter

Guillan-Barre and reactive arthritis

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43
Q

patients with PCOS are at risk for (2 things)-

A

type TWO diabetes

endometrial adenocarcinoma

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44
Q

Name two nuclear transcription factors that directly bind DNA? (can be detected with southwestern blot)

A

c-Jun and c-Fos

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45
Q

Aggression, dementia, and choreiform movements are associated with ____? Damage to what structures are characteristic?

A

Huntingtons

Caudate nucleus and putamen

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46
Q

OAA –> Citrate requires

A

B5 (CoA addition)

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47
Q

How to tx bleeding due to heparin toxicity?

A

Protamine

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48
Q

Anterior pituitary embryologic origin?

A

Surface ectoderm

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49
Q

Prolonged hypotension in the ER that produces RUQ pain is likely-

A

Acute Acalculous Cholecystitis (seen in severely ill patients)

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50
Q

BRAF

A

malignant melanoma

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51
Q

Osteomyelitis in children affects what part of bone?

A

Metaphysis due to the slow flowing blood

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52
Q

Describe the prodrome of HBV.

A

30-180 days. Serum sickness like (fever malaise rash) followed by spike in ALT and AST

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53
Q

Child immigrant with muscle weakness and RNA in CSF has ___? How is it spread??

A

Polio. Fecal-oral.

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54
Q

Describe the body volume status of SIADH

A

Euvolemic hyponatremia

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55
Q

How do you control vomiting caused by GI upset? How does the drug work?

A

Ondansetron - 5-HT receptor antagonist

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56
Q

Why are Abs to HepC ineffective?

A

Rapid antigenic variation (why making a vaccine is so hard)

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57
Q

How do you loosen mucus plugs in CF? How does the drug work specifically.

A

N-acetylcysteine - disrupts disulfide bonds

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58
Q

Receptors:
How to dilate eye?
How to reduce uterine contractions?

A

eye dilation- alpha-1 agonist

decreased uterine tone- beta-2 agonist

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59
Q

ACTH dependent Cushings- is there fasiculate later hypertrophy or hyperplasia?

A

HYPERPLASIA

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60
Q

How do tumor cell lines become resistant to chemotherapy?

A

Multidrug resistance protein 1 (MDR1) produces P-glycoprotein, which is an ATP dependent efflux pump

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61
Q

Histopathology of sickle cell spleen shows:

A

Fibrosis and atrophy

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62
Q

Why would a sickle cell patient have a high MCV?

A

Folate deficiency (prone due to the hemolytic turnover)

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63
Q

How do OCPs work?

A

Estrogen and progesterone suppress LH and FSH, preventing ovulation.

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64
Q

Spleen embryology

A

Mesodermal dorsal mesentery (although it is supplied by the celiac trunk, which supplies the foregut derived organs)

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65
Q

Inhibin decreases ___ and is produced by ____

A

FSH; Sertoli cells

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66
Q

Novobiocin Resistance =

A

Staph. Saprophyticus

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67
Q

Feared Measles complication in older children

A

SSPE

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68
Q

What are the toxicities of macrolides? (azithromycin, clarithromycin, erythromycin)

A 
M- GI Motility issues
A- Arrhythmia (long QT)
C-acute Cholestatic hepatitis
R- Rash
O- eOsinophilia
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69
Q

What viral proteins are glycosylated and then cleaved in the HIV particle?

A

gp160 –> gp120 & gp 41

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70
Q

Inflammation of the antral mucosa with inflammatory infiltrates is ___? What are these patients at risk for?

A

Type B chronic gastritis (H. Pylori). MALT.

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71
Q

How do you differentiate adenocarcinoma from mesothelioma? (histology)

A

Adenocarcinoma- Short, plump microvilli

Mesothelioma- Tumor cells with numerous, long slender microvilli and abundant tonofilaments

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72
Q

Anterior medial portion of the temporal lobe compressed against the tentorium cerebelli causes ___? (CN?)

A

Uncal herniation and damage to CNIII

  • -> Also damage to ipsilateral PCA (contralateral homon. hemianopsia)
  • -> Ipsilateral paresis (false localization sign)
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73
Q

Formula for t1/2=

A

t1/2= 0.7* (Vd/Cl)

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74
Q

XY fetus with formal Leydig cells and absent Sertoli cells will have ___.

A 
Male external (b/c Leydig make T for viril.)
Male & female internal (b/c Y chrom. makes TDF and absent Sertoli means no MIF)
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75
Q

How can morphine cause RUQ pain?

A

Can cause contraction of the smooth muscle cells in the sphincter of Oddi, leading to constriction and spasm.

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76
Q

What abx causes myopathy and elevated CPK? How does it work? What can it be used for?

A

Daptomycin
Lipopeptide that disrupts cell membranes / distort membrane potential
MRSA, bacteremia, VRE, endocarditis

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77
Q

What vitamin deficiency has similar neuro symptoms to B12?

A

E

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78
Q

What are risk factors for lung abscesses? (peptostreptococcus, fusobacterium)

A

Alcoholism, seizure disorders, drug od, severe neuro disease, and prolonged anesthesia.

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79
Q

The middle meningeal artery is a branch of what vessel?

A

Maxillary artery

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80
Q

What are the toxicities of MTX?

A

Hepatotox
Pulmonary fibrosis
Mouth ulcers
Myelosuppression (give Leucovorin)

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81
Q

Lesions in 1o vs 3o syphilis are called?

A

1o- Chancre

3o- Gumma

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82
Q

What is necrotizing enterocolitis?

A

Seen in premature formula fed infants.
Bacterial invasion and necrosis of the bowel wall.
See air in the bowel WALL

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83
Q

What are longitudinal tears in the esophagus called? What causes them?

A

Mallory Weiss tear

Increased abdominal pressure from vomiting

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84
Q

Describe positively and negatively skewed distributions. (Mean vs Median vs Mode)

A

Neg Skew = Mode>Median>Mean

Pos Skew=Mean>Median>Mode

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85
Q

Blisters that spread laterally with pressure are called

A

Pemphigus Vulgaris (Abs to desmosomes)

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86
Q

What causes painful nodule after treated laceration?

A

Retained sutures forming granulation tissue

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87
Q

Key features of Crohn’s Disease? Gross & Micro

A

GROSS- Transmural inflammation–>fistulas. Cobblestone mucosa, creeping fat, bowel wall thickening (“string sign” on barium swallow x-ray A ), linear ulcers, fissures.
MICRO- Noncaseating granulomas and lymphoid aggregates (Th1 mediated)

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88
Q

Why is HbS worse than HbC?

A

Has hydrophobic interaction among Hb molecules

* Basically HbS sickles and HcC does not*

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89
Q

Describe the Gq pathway. What happens if you block IP3?

A

binding–> PLC converts Lipids–> PIP2 –> DAG and IP3 –> increase PKC and Ca++
Block IP3–> decrease PKC activity

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90
Q

Most likely cause of death in a child with ARF is

A

Severe myocarditis causing mitral regurgitation

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91
Q

How can SAH cause limb numbness? Tx?

A

Vasospasm (from blood break down)

Tx- Nimodipine (Ca channel blocker)

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92
Q

What are snRNPs?

A

Formation of spliceosome (remove introns)

Abs to these are Anti-Smith (SLE)

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93
Q

What is tachyphylaxis with regard to decongestants?

A

The alpha agonists cause reflexive decrease in NEpi. After a few days, this leads to rebound vessel dilation and rapidly declining effectiveness after a few days.

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94
Q

In the USA, what is the main cause of liver abscesses?

A

Bacterial infection

  • Ascending cholangitis (E.Coli, Klebsiella, Enterococci)
  • Portal vein pyemia
  • Hepatic artery seeding (S. Aureus)
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95
Q

What heart diseases are caused by failure of neural crest migration?

A

TOF
Transposition
Truncus

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96
Q

What are the skin findings in Graves disease?

A

Skin thickening and induration caused by increased GAG production from fibroblasts

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97
Q

What causes jejunal, ileal, and colonic atresia?

A

Vascular accidents in utero.

Absent section of duodenum with apple peel ileum

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98
Q

Acute stress disorder vs PTSD?

A

4 weeks

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99
Q

What drug is protective against both osteoporosis and breast cancer?

A

Raloxifene

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100
Q

For the love of god, what is the subunit in fetal Hb?

A

GAMMA

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101
Q

What topical treatment is used for psoriasis? Mechanism?

A

Vitamin D analogs (calcipotriene, calcitriol, tacalcitol).
These ACTIVATE the vitamin D receptor, which is a NUCLEAR receptor.
Causes decreased keratinocyte proliferation and increased differentiation.

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102
Q

What is the most specific Ab for RA?

A

Anti-cyclic citrullinated peptide (CCP)

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103
Q

Squamous metaplasia in the pancreatic ducts of CF patients is caused by

A

Vitamin A deficiency

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104
Q

Most common secondary bacterial infections after Influenza viral infection?

A

Strep pneumo, Staph. A, H. Flu.

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105
Q

Isolated systolic htn in the elderly is caused by

A

Stiffening of aorta

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106
Q

Most common vessel for atherosclerotic involvement is

A

Abdominal aorta

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107
Q

Etoposide inhibits

A

Topoisomerase 2!!!!!!!!!!!!

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108
Q

___ is associated with asthma and CF and bronchiectasis and can present with eosinophilia

A

Aspergillus (Allergic bronchopulmonary aspergilosus)

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109
Q

Aschoff bodies

A

Granuloma with giant cells; int he myocardium of Rheumatic Fever

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110
Q

Concern about first dose of ACE i is ___.

A

First dose htn. Be careful if they are taking diuretics.

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111
Q

Chronic NSAIDS cause kidney:

A

Chronic interstitial nephritis

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112
Q

Doxorubicin causes (heart)

A

dilated CM

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113
Q

Cardiac tamponade finding

A

pulsus paradoxus

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114
Q

Jaundice early in life that can present with seizures is caused by

A

Absent UDP-glucuronosyltransferase (Crigler-Najjar)

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115
Q

In alzheimers, the decreased Ach is due to what defective brain region?

A

Nucleus basalis (of meynert)

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116
Q

N-acetyl cysteine is used to treat ____ via ____.

A

Acetaminophen overdose via sulfhydryl group donation

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117
Q

Bug with cat scratch fever? Another major presentation is ___.

A

Bartonella henselae

Bacillary Angiomatosis

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118
Q

How do you kill HepA?

A

Boil to 85 for 1 min, bleach, UV, formalin

119
Q

Another name for lactose:

A

Galactosyl b-1,4-glucose

120
Q

What is nonfunctional in xeroderma pig.?

A

Endonuclease

121
Q

How do you hear S3 best

A

Left lateral decub. AT THE END OF EXPIRATION

Brings the heart closer to the surface

122
Q

What combination of lipid lowering agents is likely to precipitate gallstones?

A

Bile acid sequestrants (cholestyramine) & Fibrates (gemfibrozil)

123
Q

What vessel is least often involved in PAN?

A

Pulmonary

124
Q

What is it called when the neuron cell body becomes rounded and the nucleus is displaced to the periphery & Nissl substance becomes dispersed throughout?

A

Axonal reaction (the Nissl substance is the RER making proteins in response)

125
Q

I say polyarteritis nodosa, you say

A

HepB

126
Q

Keloid scars are caused by

A

Excess collagen formation

127
Q

What does mechanical valve hemolysis do to haptoglobin and LDH and serum iron?

A

decreased haptoglobin
increased LDH
No change in iron

128
Q

What do you ask someone who is abused

A

Do you have a safe place to go in an emergency?

129
Q

What is the most common cause of viral UTI in kids?

A

Adenovirus (hemorrhagic cystitis)

130
Q

A hamartoma is a benign coin lesion in the lung. What it is made of?

A

Islands of mature hyaline cartilage (and fat, smooth muscle and clefts lined by respiratory epithelium)

131
Q

What is the Fick equation for Cardiac Output?

A

CO= O2 consumption/AV O2 difference

132
Q

Describe the hepatitis that is lethal in pregnant woman.

A

HEV-
RNA hepevirus, unenveloped, single stranded
fecal-oral
short incubation

133
Q

What is an immediate source for nitrogen in the urea cycle?

A

Aspartate

134
Q

How does the inactivated influenza vaccine work?

A

Induce neutralizing Abs against hemagglutinin, preventing viral entry into cells.

135
Q

What part of the intestine is ALWAYS involved in Hirshsprung disease?

A

Rectum (because the neural crest cells migrate caudally)

136
Q

Histology of acute viral hepatitis

A

Ballooning degeneration (hepatocyte swelling), mononuclear infiltrates, Councilman bodies (eosinophilic apoptotic bodies

137
Q

How does TNF-a cause insulin resistance?

A

By increasing serine phosphorylation of the tyrosine kinase insulin receptor and decreasing downstream signalling

138
Q

Sigmoid shaped ventricular septum

A

normal aging

139
Q

What are the important neutrophil chemotactic agents?

A

LTB4, 5-HETE, and C5a

140
Q

What vasculitides involve granulomas?

A

Giant cell, Takayasu

Wegeners, Churg Strauss

141
Q

TCA overdose tx (see long QT, , coma, convulsions [CCC])

A

NaHCO3

142
Q

Myxomatous changes in arteries

A

Aortic aneurysm

143
Q

Which diuretic can cause ototoxicity?

A

Furosemide (and other loop diuretics)

144
Q

Anal fissures are most commonly located

A

Below the pectinate line and Posteriorly (because Poorly Perfused)

145
Q

What factor stimulates angiogenesis?

A

FGF

146
Q

What is Fenoldopam?

A

Hypertensive emergency. D1 agonist. Vasodilation everywhere & natriuresis! (Only drug to decrease BP and increase RBF)

147
Q

How is resistance to INH accomplished?

A

Decreased expression of catalase-peroxidase enzyme (coded by KatG)

Genetic modification of binding site on mycolic acid synthesis enzyme

148
Q

Nerve with foot drop

A

Peroneal

149
Q

Describe bone in osteoporosis

A

Trabecular thinning with fewer interconnections

150
Q

What are the side effects of verapamil

A

AV block and constipation

151
Q

What do you see on a skin biopsy of eczema contact dermatitis?

A

Spongiosis

152
Q

What do you use for isolated systolic htn?

A

thiazide diuretics
or
dihydropyridine Ca antagonists (like AMLODIPINE) also causes peripheral edema

153
Q

Match the edema to the htn drug: (2)

A

ACE- angioedema

-dipine- peripheral edema

154
Q

What can be used as monotherapy in acute mania? (3)

A

Lithium
Valproate
Carbamazepine

155
Q

What things can form propionic acid?

A

Valine, Isoleucine, Threonine, Methionine
odd # FA
cholesterol side chains

156
Q

Major cytokine involved in cachexia

A

TNF-a

157
Q

Where does Renal Cell carcinoma originate?

A

PCT

158
Q

Baby with head tilted side ways is caused by

A

congenital torticollis from intrauterine malposition

159
Q

What factor, produced by the vascular endothelium, INHIBITS platelet aggregation?

A

Prostacyclin (PGI2)

160
Q

Describe stool of people with lactose intolerance (3)

A

Low pH
increased osmotic gap
Increased H2 breath content

161
Q

What renal structures are damaged in ATN?

A

PCT!!!!

also thick ascending limb

162
Q

What cardiac defect is in Downs?

A

Endocardial cushion –> ostium primum ASD and regurgitant AV valves

163
Q

What kind of receptor is JAK2?

A

Cytoplasmic tyrosine kinase

164
Q

Why is Buspirone good?

A

It is a 5HT receptor agonist with NO sedation, addiction, or tolerance!!!!

165
Q

Most common cause of acute appendicitis?

A

Lumen obstruction by fecaliths

166
Q

What do you see in the heart of someone with carcinoid syndrome?

A

Right-sided valvular disease and intimal thickening

167
Q

What energy source is needed for OAA–>PEP and where does it come from?

A

GTP; from Succinyl-CoA to Succinate

168
Q

How does Herpesvirus (including CMV…) acquire its membrane?

A

By budding through the host NUCLEAR membrane.

169
Q

What kidney stones are RADIOLUCENT?

A

Uric acid

170
Q

What are the only purely ketogenic amino acids (use for tx of PDH deficiency)

A

Lysine and Leucine

171
Q

What nerve can be damaged in the piriform recess? What reflex does this mediate?

A

internal laryngeal nerve (branch of superior laryngeal nerve X) –> Carries sensation! Therefore is the afferent limb of the COUGH reflex

172
Q

What drug to use for urinary retention

A

Bethanechol

173
Q

What type of necrosis is seen after MI?

A

Coagulative

174
Q 
Match these markers to their neoplasm:
b-hcg
AFP
CA 125
Carcinoembryonic antigen
CA 19-9
A

b-hcg- choriocarcinoma and some testicular cancer
AFP- hepatocellular cancer, yolk sac tumor
CA 125- ovarian cancer
Carcinoembryonic antigen- solid tissue tumors (for monitoring colorectal, breast, and pancreatic cancer)
CA 19-9- adenocarcinoma of the pancreas

175
Q

Parkinsons patient has gastroparesis… what do you NOT give them?

A

Metoclopramide

176
Q

I say a. fib, you say look out for

A

mural thrombi

177
Q

Why is warfarin teratogenic and heparin is not? (pharmacokinetics)

A

Lipophilic molecules cross the placenta more easily & warfarin = lipophilic.

(Heparin is a charged water soluble material so safer)

178
Q

HIV patient with white opaque patches on the retina has ____? How tx? How does tx work?

A

CMV retinitis
Ganciclovir
Inhibits DNA elongation both by incorporating into viral DNA and inhibiting viral DNA polymerase

179
Q

What is alcoholic cerebellar degeneration?

A

Chronic alcoholics can lose Purkinje cells in the anterior lobes and CEREBELLAR vermis. THis causes wide based gait and parkinsonian tremor.

180
Q

Dobutamine

A

sympathomimetic, b1>b2, a

ionotropic > chronotropic

181
Q

Phenyephrine

A

a1 agonst

182
Q

Nodules confined to the septae in cirrhosis are composed of what cells?

A

Hepatocytes

183
Q

What does the Nernst eq conclude about transmembrane potential?

A

Potential increases with increases in EXtracellular sodium/ decreases in INtracellular sodium

& vice versa

184
Q

Lactase insufficiency is caused by

A

Decreased gene expression

185
Q

What area of the brain is damaged in Kluver-Bucy syndrome?

A

Amydgala

186
Q

What causes tardive dyskinesia?

A

Long term use of antipsychotics can cause upregulation of dopamine receptors

187
Q

Acitretin

A

Systemic psoriasis tx
Synthetic retinoid
Teratogenic!

188
Q

Which rectal vein drains into portal circulation?

A

Superior rectal –> inferior mesenteric –>portal vein

Middle rectal vein –> common iliac vein & Inferior rectal vein –> pudendal vein –> both to SYSTEMIC

189
Q

What intestinal parasite has phagositized RBCs?

A

Entamoeba histolytica

190
Q

Excessive ___ of ____muscle can cause lumbar lordosis.

A

Flexion of hip

191
Q

Why does serum insulin increase more with PO glucose than IV glucose?

A

Intestine produces incretins, such as glucagon-like peptide 1 that help increase insulin, independent of blood levels.

192
Q

The skin nodules in NF1 are made of what cell?

A

Schwann Cell

193
Q

What can a patient take to reduce effects of niacin?

A

Aspirin (because blocks prostaglandin production that dilates vessels.

194
Q

Describe Ulcerative Colitis morphology

A

Neutrophils in the crypt abscesses and ulcerations (not through the submucosa)

195
Q

What antidepressant can cause urinary retention and tachycardia?

A

Amitriptyline (because it has alpha antagonist properties)

196
Q

How does paclitaxel effect stents?

A

Prevents restenosis due to intimal hyperplasia

197
Q

If proline is not hydroxylated in collagen, what happens?

A

Abnormal triple helix formation

198
Q

Psoas attachments

A

Lesser trochanter of the femur (in the groin)
&
T12-L4 vertebral bodies

199
Q

Accumulation of microsatellites predisposes to

A

colorectal carcinoma (HNPCC) because mutations in mismatch repair enzymes can lead to microsatellite instability

200
Q

Renal tumor + lower extremity edema + visible abdominal wall collateral circulation =

A

Obstruction of the IVC

201
Q

Dermoepidermal junction aggregates of large cells that fuse with adjacent nests

A

Dysplastic nevus syndrome @ increased risk for melanoma

202
Q

Drug X, when given with GABA, increases Cl- conductivity. This effect is not reversed with Flumazenil.

A

X= Barbiturates (like phenobarbital)

203
Q

What crosses the diaphragm at
T8
T10
T12

A

T8- IVC
T10- esophagus + CN10
T12- Aorta + thoracic duct + azygous vein

204
Q

What enzyme traps glucose in b-islets?

A

Glucokinase

205
Q

What electrolyte can cause nephrogenic DI?

A

Hypercalcemia

206
Q

Gp2b/3a is what type of receptor?

A

Integrin

207
Q

Why is it bad to give a kid with Von Gierke’s glucose?

A

Glucose-6-phosphatase is needed in gluconeogenesis to turn fructose into glucose.

208
Q

Start someone on niacin that has HTN and diabetes. How should you adjust meds?

A

Decrease htn meds

Increase diabetes meds

209
Q

Pulmonary actinomyces (anaerobic) …. remember what this looks like?

A

http://www.hindawi.com/journals/crim/2010/282167.fig.002b.jpg

210
Q

Combined UMN and LMN disease of the anterior spinal tracts =

A

ALS

211
Q

Severe onset chest pain radiating to the back is caused by what mechanism?

A

intimal tearing

212
Q

What part of hepatitis virus forms spheres and tubules apx 22nm in diameter?

A

Envelope of HBV

213
Q

How does the body turn pro-carcinogens (like benz-o-pyrene) into carcinogens?

A

Microsomal monooxygenase (p450)

214
Q

What purine analog, used to treat hairy cell leukemia, is resistant to degradation by adenosine deaminase?

A

Cladribine

215
Q

The TSST from tampons is caused by interaction of what cells?

A

Superantigen binds T-cells and macrophages, leading to IL-2, TNF-a, and IL-1 production –> shock

216
Q

How can you tell is B-cell or T-cell ALL?

A

T-cell has mediastinal compression with possible stridor

217
Q

HCV RNA dep RNA pol lacks ___ activity –> hypervariable

A

3’-5’ exonuclease activity

218
Q

How do you prevent a newborn from getting group B strep?

A

Intrapartum ampicillin or penicillin

Check mother at 35-37 weeks for GBS

219
Q

Painful bluish lesion under nail is ___ derived from ____ cells.

A

Glomus tumor from thermoregulatory cells

220
Q

Chronic rejection affects what part of lung allograft?

A

Small airways (bronchiolitis obliterans)

221
Q

What are the 2 presentations of cryptococcus? You can stain with either India ink or _____ and it looks red!

A

Meningitis or pulmonary infection

Mucicarmine

222
Q

How does isoproterenol decrease BP?

A

Beta-2 receptor stimulation causes vasodilation

223
Q

If aspirate while supine, where does the aspirate go?

A

Inferior segment of upper lobe

Superior segment of lower lobe

224
Q

Which sympathetic G-protein receptor increases insulin release? Decreases insulin release?

A 
beta-2= INCREASE insulin release
alpha-2= DECREASE insulin release
225
Q

How quickly is glycogen depleted? Then what does the body do?

A

12-18 hours of fasting

then glycogenolysis

226
Q

Who gets apical subpleural blebs?

A

Tall thin young males (These predispose to spontaneous pneumothorax)

227
Q

What are pancreatic pseudocysts lined with?

A

Fibrous and granulation tissue (Note*** that only TRUE cysts are lined with epithelium.

228
Q

What cell provides the proliferative stimuli for atherosclerotic plaques?

A

Platelets - PDGF

229
Q

What lung diseases cause clubbing?

A

large-cell carcinoma, TB, CF, bronchiectasis, pulm htn, empyema

230
Q

B-symptoms, bilateral hilar adenopathy, and non-caseating granulomas

A

Sarcoidosis

231
Q

Where is the CTZ trigger zone? (vomit center)

A

dorsal surface of the medulla near the 4th ventricle

232
Q

Renal complication of sickle cell

A

Renal papillary necrosis

233
Q

How do you differentiate pilocytic astrocytoma and medulloblastoma?

A 
Pilocytic = lateral cerebellum and well-circumscribed
Medulloblastoma = midline cerebellum and aggressive with lots of mitoses
234
Q

Which lipid drug can cause gout?

A

Niacin (can also cause hyperglycemia, hyperuricemia, and hepatitis)

235
Q

What happens to alveoli in ARDS?

A

Hyaline membranes form

236
Q

Restrictive, fibrosis, cyst formation

A

Idiopathic pulmonary fibrosis

237
Q

Precursor of NO?

A

Arginine

238
Q

Rheumatic disease…. what comes FIRST: mitral stenosis or regurgitation?

A

M. regurgitation 1st

M. stenosis 2nd

239
Q

Compression of what nerve root causes pain strictly in the posterior thigh and leg shooting to the foot, with decreased plantar flexion and loss of ankle jerk

A

S1

240
Q

Knee jerk reflex nerve levels

A

L2-4

241
Q

Trigeminal neuralgia initial tx

A

Carbamazepine

242
Q

Giant cell arteritis patients have _____ disease 50% of the time.

A

Polymyalgia rheumatica (pelvic and shoulder girdle pain)

243
Q

How treat idiopathic pulmonary arterial hypertension? (What must you monitor on the med?)

A

Bosentan- a competitive antagonist of the endothelin receptors
*Check LFTs!

244
Q

What senses PaCO2?

What senses PaO2?

A

CO2- central chemoreceptors

O2- Carotid and aortic bodies

245
Q

What medication for gestational diabetes?

A

insulin

246
Q

Angiomyolipomas are associated with

A

Tuberous Sclerosis

247
Q

Homeobox codes for

A

transcription factors/regulators

248
Q

In patients with essential fructosuria, they remain able to use some fructose in glycolysis through the enzyme _____.

A

Hexokinase

249
Q

What is a P body?

A

RNA regulation and turnover in the CYTOPLASM

250
Q

How to reduce cisplatin toxicity?

A

Amifostine

251
Q

Fatigability and weight gain and elevated Creatine Kinase

A

Hypothyroid myopathy

252
Q

Hibernation vs stunning

A

Low flow state –> hibernation (reversed by CABG)

Ischemia induced, reversible, loss of contractility –> Stunning

253
Q

Classic galactosemia inheritance

A

Autosomal Recessive

254
Q

What hormone signals by increasing cGMP?

A

ANP

255
Q

Which benzos are short acting?

Long acting?

A 
Short = ATOM
Long= F CDC
256
Q

What can halothane do to the liver?

A

massive hepatic necrosis!

257
Q

What disease has a rash that starts at the head and spreads down AND has posterior auricular lymphadenopathy?

A

RUBELLA (togavirus)

258
Q

What is a rare but serious consequence of anti-thyroid drugs?

A

Angranulocytosis

259
Q

Why does left heart failure cause dyspnea?

A

Decreased pulmonary compliance due to pulmonary edema

260
Q

What does PAS stain?

A

glycoprotein

261
Q

What can be used to diagnose Prinzmetals? (transient nighttime angina with ST elevations)

A

Ergonovine

262
Q

Which antipsychotics have more neurologic side effects?

A

High potency (Trifluoperazine, Fluphenazine, Haloperidol (Try to Fly High))

263
Q

Start abx for UTI and 5 days later get a rash and fever with eosinophils

A

Interstitial nephritis

264
Q

How does Reye syndrome cause coma?

A

cerebral edema

265
Q

Sigmoid colon metastasizes to what node?

A

Inferior mesenteric

266
Q

Sildenafil is contraindicated in patients taking

A

nitrates

267
Q

What is Kussmauls sign?

A

Rise in JVP with inspiration because the constrictive pericarditis cannot accommodate the increase in volume

268
Q

How to treat serotonin syndrome?

A

Cyproheptadine (antihistamine with anti-serotonin properties)

269
Q

How does the toxin responsible for the diarrhea in C.diff work?

A

Toxin B (cytotoxin)- disrupts actin cytoskeleton integrity and inactivates regulatory proteins involved in signal transduction

270
Q

What are the causes of metabolic alkalosis? First lab to order to differentiate?

A

Vomiting
Thiazide use
Hyperaldosteronism
–> Order Cl- because only vomiting will have low Cl-

271
Q

Old man with back pain and large obstructing eosinophilic casts (and no rx history) has

A

multiple myeloma (Bence Jones protein casts)

272
Q

How does uremia cause bleeding?

A

Increased bleeding time through platelet dysfunction

Normal # of platelets, Normal PT and PTT

273
Q

What drugs can cause hypothyroidism? (one is an antipsych)

A

Lithium, amiodarone, sulfonamides

274
Q

What diuretics can cause pulmonary edema

A

mannitol (the osmotic ones)

275
Q

Antidote to arsenic poisoning

A

Dimercaprol

276
Q

Which nitrate has the highest bioavailability if given orally?

A

Isosorbide MONOnitrate

277
Q

FenFen causes death via

A

pulmonary htn and right sided heart failure that can lead to an arrythmia

278
Q

Mast cells release histamine and

A

tryptase

279
Q

What bone structural changes occur in primary hyperparathyroidism?

A

subperiosteal resorption with cystic degeneration

“brown tumors”

280
Q

What antiviral that can be used for CMV causes hypocalcemia, hypomagnesia, and seizures?

A

foscarnet

281
Q

Pure RBC aplasia is associated with

A

THYMOMA, LYMPHOCYTIC LEUKEMIAS, AND PARVO B19

282
Q

What is BRCA?

A

DNA repair protein (tumor suppressor)

283
Q

Side effect of bupropion in bulimic/anorexic patients?

A

Seizures

284
Q

Diaphragmatic surface of the heart is supplied by

A

the posterior descending artery (arises from RCA in most people)

285
Q

Which platelet/coag drug causes thrombocytopenia? Neutropenia?

A 
Thrombocytopenia = heparin
Neutropenia = Ticlopidine
286
Q

Combination absence and tonic clonic seizure tx

A

Valpoic acid

287
Q

Most common CV manifestation of SLE

A

pericarditis

288
Q

Tx of cyanide poisoning?

A

thiosulfate (sulfer)
or hydroxocobalamin
or nitrite

289
Q

Essential tremor (gets better with EtOH) is tx with

A

b-blockers

primidone

290
Q

Massive diarrhea with a lack of gastric acid secretion that is treated with somatostatin is

A

VIPoma

291
Q

What is a specific finding in graves disease (one you usually forget)

A

Pretibial myxedema

292
Q

Mechanism of kidney stones in Crohns

A

Oxalate stones -

Inflamed ileum –> decreased bile acid resorption –> increased fat in stool –> calcium binds fat = soaponification –> oxalate does not bind as much calcium and therefore more oxalate is absorbed –> kidney stones

293
Q

RALES trial showed that the addition of what diuretic improved survival in heart failure patients?

A

Spironolactone

294
Q

Which lymphoma causes waxing and waning (it is very common)

A

Follicular (14;18) bcl-2

UWorld Wrongs (1 decks)

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